Archived: Abbegale Lodge

Abbegale Lodge is a residential care home providing accommodation for up to 41 people. The home consists of two converted Victorian villas with a two storey modern extension and supports people with mental health and dementia care needs. There is a passenger lift in the main building with a stair lift in place at the other villa and extension. The service provides upper and ground floor accommodation. There is a large garden to the rear of all three buildings. It is within easy walking distance of The Strand shopping centre in Bootle

A manager was in post who was in the process of registering with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are registered persons. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Process relating to the safe administration of medications were in place within the home, and the home was addressing any issues to help mitigate risks.

People and relatives we spoke with told us they felt safe living at the home.

Risk assessments were in place and personalised.

The staff we spoke with were aware of what constituted abuse and how to report an alleged incident.

Recruitment procedures were robust to ensure staff were suitable to work with vulnerable people. Systems were in place to maintain the safety of the home. This included health and safety checks of the equipment and building

Staff told us they were well supported in the home and had an induction when they first started work, and had regular supervision and appraisal.

People had a plan of care in place which was personalised and contained information such as their likes, dislikes and backgrounds.

The registered manager and the staff had knowledge of the Mental Capacity Act 2005 and their roles and responsibilities linked to this. Staff support was available to assist people to make key decisions regarding their care.

The home had aids and equipment to meet people’s needs and promote their independence.

We found the home to be clean, warm and homely, although the décor required attention in some places. There was a strong smell of smoke which was present in most of the areas of the home.

Everyone told us the staff were caring and we could see evidence that the staff genuinely cared about the people they supported.

Food was fresh and home cooked. Everyone we spoke with told us that they enjoyed the food.

Staff worked well with health and social care professionals to make sure people received the care and

support they needed. Staff referred to outside professionals promptly for advice and support.

A process was in place for managing complaints and the home’s complaints procedure was available so people had access to this information.

People and relatives told us that the manager was approachable and supportive.

Staff were aware of the homes whistleblowing policy and told us they would not hesitate to report any concerns or bad practice.

Systems were in place to monitor the standard of the service and drive forward improvements. This included a number of audits for different areas of practice.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who lived at the home, their relatives, staff providing support and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

The people we spoke with told us staff were caring. Our observations confirmed this.

The home was clean, hygienic and odour free. Measures were in place to ensure the environment was safe and suitable for the people who were living there.

Staff told us there was enough staff on duty to ensure people's safety. The manager set the staff rotas; they took people's care needs into account when making decisions about the numbers of staff required. This helped to ensure that people's needs were always met.

The home protected the rights and welfare of the people in accordance with the Mental Capacity Act (2005). At the time of the inspection there was one Deprivation of Liberty Safeguards (DoLS) in place. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

Is the service effective?

It was not always possible to get the views of people who lived at the home due to their frailty and level of confusion. People we spoke with did however tell us they were happy with the support they received from the staff. We could see that staff acted promptly if a person needed to see a health professional, such as the GP, chiropodist or district nurse.

People's health and care needs were assessed with them and/or with a family member. People and family members told us staff communicated well about care needs and any changes were discussed with them. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People's care plans reflected their current needs.

Where specialist support was needed, for example, with a person's nutrition, mobility and use of equipment, this had been sought in a timely manner to help improve people's health, well-being and independence.

Is the service caring?

People told us they were supported by kind and attentive staff. We observed staff supporting people in a caring, friendly and respectful way. A person living there said, "It's very good here." A relative we spoke with told us, "My family member has everything they need. I have no cause for complaint."

Staff were knowledgeable about people's preferences, interests and diverse needs so care and support was provided in accordance with people's wishes.

Is the service responsive?

People knew how to make a complaint or raise a concern if they were dissatisfied with something.

From our discussions with staff and looking at a number of care records we could see that people's plan of care was revised to meet any change in need, for example, deterioration in a person's medical condition. Care documents showed medical intervention had been sought at the appropriate time.

Is the service well-led?

The home had appointed a manager but they were not registered with the Care Quality Commission [CQC]. They informed us they had recently submitted an application to us for this position. Our records confirmed this.

The home had systems in place to regularly monitor the quality and safety of the service provided. Records we looked at demonstrated that action plans were developed to address identified shortfalls in a timely way.

We saw evidence to show staff regularly attended mandatory training courses to update their knowledge. They all received supervision sessions from the manager every three months. Records showed this last took place in May 2014. This helped to ensure that people received a good quality service at all times.

The service worked in partnership with key organisations, including the local authority and safeguarding teams to support the care provision and service development. This was evidenced through looking at a number of records and talking with the manager and staff.

During our observations we saw that people were offered a choice of food at lunchtime. We saw one member of staff asking people individually what they preferred to have for their dessert from the food available. This showed people made their own choices.

On checking medication management we found that people received their medicines as prescribed. We found records regarding medication were accurate.

We observed staff interacting with people who lived in the service during our visit. We observed some examples of where staff supported people well, such as acknowledging anxieties and attempting to reassure them. We spoke with some people living in the home during our visit they told us: "I like the staff, they know how to support me” and “The staff here are very good”.